Michael A Scaffidi1, Samir C Grover2, Heather Carnahan3, Jeffrey J Yu4, Elaine Yong5, Geoffrey C Nguyen6, Simon C Ling7, Nitin Khanna8, Catharine M Walsh9. 1. Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. 2. Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. 3. School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, Newfoundland, Canada. 4. Wilson Centre, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. 5. Division of Gastroenterology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. 6. Division of Gastroenterology, Mount Sinai Hospital University of Toronto, Toronto, Ontario, Canada; Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. 7. Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. 8. Division of Gastroenterology, St. Joseph's Health Centre, University of Western Ontario, London, Ontario, Canada. 9. Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Wilson Centre, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Abstract
BACKGROUND AND AIMS: Colonoscopy performance is typically assessed by a supervisor in the clinical setting. There are limitations of this approach, however, because it allows for rater bias and increases supervisor workload demand during the procedure. Video-based assessment of recorded procedures has been proposed as a complementary means by which to assess colonoscopy performance. This study sought to investigate the reliability, validity, and feasibility of video-based assessments of competence in performing colonoscopy compared with live assessment. METHODS: Novice (<50 previous colonoscopies), intermediate (50-500), and experienced (>1000) endoscopists from 5 hospitals participated. Two views of each colonoscopy were videotaped: an endoscopic (intraluminal) view and a recording of the endoscopist's hand movements. Recorded procedures were independently assessed by 2 blinded experts using the Gastrointestinal Endoscopy Competency Assessment Tool (GiECAT), a validated procedure-specific assessment tool comprising a global rating scale (GRS) and checklist (CL). Live ratings were conducted by a non-blinded expert endoscopist. Outcomes included agreement between live and blinded video-based ratings of clinical colonoscopies, intra-rater reliability, inter-rater reliability and discriminative validity of video-based assessments, and perceived ease of assessment. RESULTS: Forty endoscopists participated (20 novices, 10 intermediates, and 10 experienced). There was good agreement between the live and video-based ratings (total, intra-class correlation [ICC] = 0.847; GRS, ICC = 0.868; CL, ICC = 0.749). Intra-rater reliability was excellent (total, ICC = 0.99; GRS, ICC = 0.99; CL, ICC = 0.98). Inter-rater reliability between the 2 blinded video-based raters was high (total, ICC = 0.91; GRS, ICC = 0.918; CL, ICC = 0.862). GiECAT total, GRS, and CL scores differed significantly among novice, intermediate, and experienced endoscopists (P < .001). Video-based assessments were perceived as "fairly easy," although live assessments were rated as significantly easier (P < .001). CONCLUSIONS: Video-based assessments of colonoscopy procedures using the GiECAT have strong evidence of reliability and validity. In addition, assessments using videos were feasible, although live assessments were easier.
BACKGROUND AND AIMS: Colonoscopy performance is typically assessed by a supervisor in the clinical setting. There are limitations of this approach, however, because it allows for rater bias and increases supervisor workload demand during the procedure. Video-based assessment of recorded procedures has been proposed as a complementary means by which to assess colonoscopy performance. This study sought to investigate the reliability, validity, and feasibility of video-based assessments of competence in performing colonoscopy compared with live assessment. METHODS: Novice (<50 previous colonoscopies), intermediate (50-500), and experienced (>1000) endoscopists from 5 hospitals participated. Two views of each colonoscopy were videotaped: an endoscopic (intraluminal) view and a recording of the endoscopist's hand movements. Recorded procedures were independently assessed by 2 blinded experts using the Gastrointestinal Endoscopy Competency Assessment Tool (GiECAT), a validated procedure-specific assessment tool comprising a global rating scale (GRS) and checklist (CL). Live ratings were conducted by a non-blinded expert endoscopist. Outcomes included agreement between live and blinded video-based ratings of clinical colonoscopies, intra-rater reliability, inter-rater reliability and discriminative validity of video-based assessments, and perceived ease of assessment. RESULTS: Forty endoscopists participated (20 novices, 10 intermediates, and 10 experienced). There was good agreement between the live and video-based ratings (total, intra-class correlation [ICC] = 0.847; GRS, ICC = 0.868; CL, ICC = 0.749). Intra-rater reliability was excellent (total, ICC = 0.99; GRS, ICC = 0.99; CL, ICC = 0.98). Inter-rater reliability between the 2 blinded video-based raters was high (total, ICC = 0.91; GRS, ICC = 0.918; CL, ICC = 0.862). GiECAT total, GRS, and CL scores differed significantly among novice, intermediate, and experienced endoscopists (P < .001). Video-based assessments were perceived as "fairly easy," although live assessments were rated as significantly easier (P < .001). CONCLUSIONS: Video-based assessments of colonoscopy procedures using the GiECAT have strong evidence of reliability and validity. In addition, assessments using videos were feasible, although live assessments were easier.
Authors: Michael A Scaffidi; Catharine M Walsh; Rishad Khan; Colleen H Parker; Ahmed Al-Mazroui; Michael Abunassar; Alexander W Grindal; Peter Lin; Christopher Wang; Robert Bechara; Samir C Grover Journal: Endosc Int Open Date: 2019-05-03
Authors: B Joseph Elmunzer; Catharine M Walsh; Gretchen Guiton; Jose Serrano; Amitabh Chak; Steven Edmundowicz; Richard S Kwon; Daniel Mullady; Georgios I Papachristou; Grace Elta; Todd H Baron; Patrick Yachimski; Evan L Fogel; Peter V Draganov; Jason R Taylor; James Scheiman; Vikesh K Singh; Shyam Varadarajulu; Field F Willingham; Gregory A Cote; Peter B Cotton; Violette Simon; Rebecca Spitzer; Rajesh Keswani; Sachin Wani Journal: Gastrointest Endosc Date: 2020-07-30 Impact factor: 9.427
Authors: Jessica C Wise; Edwina J A Wilkes; Sharanne L Raidal; Gang Xie; Danielle E Crosby; Josephine N Hale; Kristopher J Hughes Journal: J Vet Intern Med Date: 2020-12-07 Impact factor: 3.175